Mountaintop removal mining destroys forest ecosystems and clogs streams with often toxic mining waste. And according to a new study, it also increases a person’s risk of lung cancer.

The study, published this week in the journal Environmental Science and Technology, looks at the carcinogenic potential of the particulate matter that enters the air during mountaintop removal mining, a form of surface mining that blasts the tops of mountains away so that underground coal reserves can be accessed. The study found “new evidence” that breathing in this particulate matter over an extended period of time can lead to lung cancer, confirming previous research that has found increased cases of lung cancer in communities that live near coal mining operations in Appalachia. That research noted that smoking rates in these communities are likely also contributing to the lung cancer risk, making exposure to mining operations only one of the variables involved, but this week’s research confirms, for the first time, that dust from mining operations can drive up a person’s risk of lung cancer.

“It’s a risk factor, with other risk factors, that increases the risks of getting lung cancer,” study co-author and West Virginia University cancer researcher Yon Rojanasakul told the Charleston Gazette. “That’s what the results show.”

The researchers exposed lung cells to dust from mountaintop removal operations over a three-month period. They found that the dust had “cell-transforming and tumor-promoting effects” — it led to certain changes in the cells that promoted lung cancer development.

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“As more than 60,000 cancer cases has been estimated to correlate with MTM [mountaintop removal] activities in West Virginia, this finding on the cancer promoting effect of [particulate matter] and related epidemiological data are crucial to raise public health awareness to reduce cancer risk,” the study’s authors write.

Environmentalists and some Appalachian residents have fought against mountaintop removal, which is considered to be the most destructive way to extract coal, for years. According to anti-mountaintop removal group Appalachian Voices, the practice has destroyed more than 500 mountains so far in central and southern Appalachia. Blowing up the tops of these mountains obliterates temperate forest ecosystems that are among the most biologically diverse in the world.

The operations can blast away up to 400 vertical feet of a mountain’s summit, and this, plus the process of mining the coal itself, creates large amounts of waste, which has historically been dumped in valleys. This practice actually destroys streams. Chief U.S. District Judge Charles H. Haden II wrote about the disposal practice in a 1999 ruling that concluded that these “valley fills” violated the Clean Water Act.

“The normal flow and gradient of the stream is now buried under millions of cubic yards of excess spoil waste material, an extremely adverse effect,” the judge wrote. “If there are fish, they cannot migrate. If there is any life form that cannot acclimate to life deep in a rubble pile, it is eliminated. No effect on related environmental values is more adverse than obliteration.”

According to the EPA, valley fills still occur in mountaintop removal operations that are located in “steep terrain where there are limited disposal alternatives.” This waste disposal practice, along with the blasting and coal mining process itself, threatens the water supply of Appalachian residents. In September, some of these residents rallied at the White House, saying that the Obama administration needed to do more to address the health and environmental impacts of mountaintop removal mining.

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“We think the Obama administration should make this one of his legacies — protecting Appalachian water,” Ann Leauge, member of the Alliance for Appalachia, said. “It’s one of the things he mentioned in his campaign in 2008 — that mountains should not be blown up to get to the coal below — and we want him to follow through on that.”

Some Appalachian lawmakers agree that the health and environmental impacts of mountaintop removal mining need to be addressed — especially now that this study links mountaintop removal process to cancer.

“We have clear scientific evidence that mountaintop removal coal mining jeopardizes the health of coalfield residents, and today’s study is more proof that we can no longer ignore the dangerous impact of this destructive practice,” Rep. John Yarmuth (D-KY) said in a statement. “No one should have to breathe the dirty air or drink the polluted water in mountaintop removal communities, but as long as we allow this public health hazard to continue, we are forcing the residents of Appalachia to do exactly that.”